The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition
Metadatos
Mostrar el registro completo del ítemAutor
Morón, Rocío; Gálvez Peralta, Julio Juan; Colmenero, Manuel; Anderson, Per Olof; Cabeza, José; Rodríguez Cabezas, María ElenaEditorial
MDPI
Materia
Critically ill patient Microbiome Nutrition Probiotics Fecal microbiota transplantation Synbiotics
Fecha
2019-12-07Referencia bibliográfica
Moron, R., Galvez, J., Colmenero, M., Anderson, P., Cabeza, J., & Rodriguez-Cabezas, M. E. (2019). The Importance of the Microbiome in Critically Ill Patients: Role of Nutrition. Nutrients, 11(12), 3002.
Patrocinador
This work was supported by Junta de Andalucía (Spain) (research grants CTS 164 and PI-0206-2016) and cofinanced by the Fondo Europeo de Desarollo Regional (FEDER) from the European Union. RM has a Río Hortega contract (CM17/00237) and PA has a Nicolás Monardes contract (C-0013-2018).Resumen
Critically ill patients have an alteration in the microbiome in which it becomes a
disease-promoting pathobiome. It is characterized by lower bacterial diversity, loss of commensal
phyla, like Firmicutes and Bacteroidetes, and a domination of pathogens belonging to the
Proteobacteria phylum. Although these alterations are multicausal, many of the treatments
administered to these patients, like antibiotics, play a significant role. Critically ill patients also
have a hyperpermeable gut barrier and dysregulation of the inflammatory response that favor the
development of the pathobiome, translocation of pathogens, and facilitate the emergence of sepsis. In
order to restore the homeostasis of the microbiome, several nutritional strategies have been evaluated
with the aim to improve the management of critically ill patients. Importantly, enteral nutrition
has proven to be more efficient in promoting the homeostasis of the gut microbiome compared to
parenteral nutrition. Several nutritional therapies, including prebiotics, probiotics, synbiotics, and
fecal microbiota transplantation, are currently being used, showing variable results, possibly due
to the unevenness of clinical trial conditions and the fact that the beneficial effects of probiotics are
specific to particular species or even strains. Thus, it is of great importance to better understand the
mechanisms by which nutrition and supplement therapies can heal the microbiome in critically ill
patients in order to finally implement them in clinical practice with optimal safety and efficacy.